Supershrinks: What is the secret of their success?

Supershrinks: What is the secret of their success?

by Barry Duncan, PhD and Scott Miller, PhD

Clients of the best therapists improve at a rate at least 50-percent higher and drop out at a rate at least 50-percent lower than those of average clinicians. What is the key to superior performance?
Clients of the best therapists improve at a rate at least 50 percent higher and drop out at a rate at least 50 percent lower than those of average clinicians. What is the key to superior performance? Are "supershrinks" made or born? Is it a matter of temperament or training? Have they discovered a secret unknown to other clinicians or are their superior results simply a fluke, more measurement error than reality? We know that who provides the therapy is a much more important determinant of success than what treatment approach is provided. The age, gender, and diagnosis of the client have no impact on the treatment success rate, nor do the experience, training, and theoretical orientation of the therapist. In attempting to answer these questions, Miller, Hubble and Duncan, have found that the best of the best simply work harder at improving their performance than others and attentiveness to feedback is crucial. When a measure of the alliance is used with a standardized outcome scale, available evidence shows clients are less likely to deteriorate, more likely to stay longer, and twice as likely to achieve a change of clinical significance.
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Copyright © 2008 Psychotherapy in Australia, reprinted with permission.
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Barry Duncan and Scott Miller are co-founders of the Institute for the Study of Therapeutic Change. Together, they have authored and edited numerous professional articles and books, including The Heart and Soul of Change: What Works in Therapy, Escape from Babel, Psychotherapy with Impossible Cases, and The Heroic Client. Recently, they released self-help books, Staying on Top and Keeping the Sand Out of Your Pants: A Surfer's Guide to the Good Life, and What's Right with You: Debunking Dysfunction and Changing Your Life.
It should surprise no one that we cannot objectively measure improvement in psychotherapy, because we can objectively define neither psychotherapy nor its goals.
steph k
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CE credits: 1.5
Learning objectives:

  • Describe what sets supershrinks apart from the rest of their peers.
  • Identify practical strategies for improving your effectiveness as a therapist
  • Apply outcome measures to your work with clients
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